<!DOCTYPE html>
<html>
    <head>
        <meta charset="utf-8" />
        <meta name="viewport" content="width=device-width, initial-scale=1" />
        <title>Email Agent</title>
        <link rel="stylesheet" href="http://code.jquery.com/mobile/1.2.0-alpha.1/jquery.mobile-1.2.0-alpha.1.min.css" />
        <link rel="stylesheet" type="text/css" href="js/jquery-ui-1.8.23/css/redmond/jquery-ui-1.8.23.custom.css">        <link rel="stylesheet" href="my.css" />
        <link rel="stylesheet" type="text/css" href="daria.css">
        
        <style>
            /* App custom styles */
        </style>
        <script src="http://code.jquery.com/jquery-1.8.0.min.js"></script>
        <script type="text/javascript" src="js/jquery-ui-1.8.23/js/jquery-ui-1.8.23.custom.min.js"></script>
		<script src="http://code.jquery.com/mobile/1.2.0-alpha.1/jquery.mobile-1.2.0-alpha.1.min.js"></script>
		<script src="my.js"></script>
		<script src="EventToPhp.js">
    	</script>
</head>
<body>
<!-- Home -->
<div data-role="page" id="pageemailagent">
    <div data-role="content" style="padding: 15px" id="content">
        <div class="ui-grid-a">
            <div class="ui-block-a">
                <h4>
                    Name*
                </h4>
            </div>
            <div class="ui-block-b">
                <input name="" id="textinput1" placeholder="" value="" type="text">
            </div>
        </div>
        <div class="ui-grid-a">
            <div class="ui-block-a">
                <h4>
                    Email Address*
                </h4>
            </div>
            <div class="ui-block-b">
                <input name="" id="textinput1" placeholder="" value="" type="text">
            </div>
        </div>
        <div class="ui-grid-a">
            <div class="ui-block-a">
                <h4>
                    Telphone Number*
                </h4>
            </div>
            <div class="ui-block-b">
                <input name="" id="textinput1" placeholder="" value="" type="text">
            </div>
        </div>
        <div class="ui-grid-a">
            <div class="ui-block-a">
                <h4>
                    Borrow Ammount*
                </h4>
            </div>
            <div class="ui-block-b">
                <input name="" id="textinput1" placeholder="" value="" type="text">
            </div>
        </div>
        <div class="ui-grid-a">
            <div class="ui-block-a">
                <h4>
                    Found a property*
                </h4>
            </div>
            <div class="ui-block-b">
            <fieldset data-role="controlgroup">
                <select name="toggleswitch1" id="toggleswitch1" data-theme="b" data-role="slider">
                    <option value="off">
                        Off
                    </option>
                    <option value="on">
                        On
                    </option>
                </select>
            </fieldset>
                
            </div>
        </div>
        <div class="ui-grid-a">
            <div class="ui-block-a" style="width:50%;">
                <a href="#" id="pageemailagentcancel" data-rel="back" data-role="button" data-transition="fade">
                    Cancel
                </a>
            </div>
            <div class="ui-block-b" style="width:50%;">
                <a href="#" id="pageemailagentcancel" data-role="button" data-transition="fade" data-theme="a">
                    Send
                </a>
            </div>
        </div>
        <div>
        </div>

    </div>
</div>
</body>
</html>